Emporia State School of Business + Technology
Salutation:
Formal First Name:
Preferred First Name:
Middle Initial:
Last Name:
Suffix:
Gender:
Street Address:
Street Address 2:
City:
State:
Zip Code
Phone Number:
E-mail:
Employment Status:
Company or company you retired from:
Title:
Industry:
City where you work or worked:
State where you work or worked:
How many years of professional experience do you have?
Areas of expertise:
Why are you interested in becoming a mentor?
If necessary, would you be comfortable having two mentees?
Do you have any mentee preferences (e.g. Freshman Accounting major, student from the Emporia area, a female or male student, a specific student's name, etc.)
